One way of achieving this is through Universal Health Coverage (UHC) for the population at large. UHC stipulates that “all people have access to essential health services without the financial hardship associated with payment” (Lancet 2010). The necessity of UHC have been emphasized in global forums again and again [e.g., WHA resolutions in 2008 and 2011, WH Reports in 2008 (PHC: now more than ever) and 2010 (Health financing), Commission on Social Determinants of Health 2008, First World Social Security Report 2010 etc.). Also, countries like India, Vietnam, Thailand, Ghana, Rwanda are marching ahead to the road of UHC since the beginning of the 21st century. As the movement for UHC intensifies in other parts of the world, there is an imperative to prepare Bangladesh for it!
Bangladesh currently spends only US$ 16 per capita for health annually, a part of which comes from development partners. This is only 3.5% of GDP which is far behind other countries such as Nepal and Bhutan (≥4%). For embarking on the road to the UHC, innovative ways to mobilize internal resources are needed. These may include new taxes (earmarked and un-earmarked), diaspora bonds for the large number of overseas Bangladeshis, and (additional) excise tax on unhealthy products such as cigarettes, foodstuff and ingredients. Improving the negotiating capacity of MoH with MoF could yield positive results in terms of increased allocation for health in the national budget paving the way for quick transition to UHC. More importantly, with the rise in the country’s GDP, there more money should be available for health.
The Bangladesh Health Watch Report 2011, launched on 20th February in BRAC Centre INN, Dhaka, in presence of the Health Minister, Finance Minister and the Nobel Laureate Amartya Sen, dealth with the these issues of UHC. In this year’s report, several studies have been undertaken to investigate Bangladesh’s preparedness to achieve UHC within the foreseeable future, and identify opportunities as well as challenges which need to be overcome. The studies have looked at various demand and supply-side issues, the different models of health insurance, experiences of low and middle income countries in this regard and finally tried to curve a path for Bangladesh to move forward.